WASHINGTON ― House and Senate GOP leaders are assuring their members that the so-called “skinny repeal” bill that would do away with parts of Obamacare is just another vote to advance the health care process ― that this bill alone won’t become law. But Senate Republicans still have concerns, with good reason: House Republicans don’t hate the bill, and no one can make the types of promises that senators are being sold on.
On Thursday, just hours before the Senate was supposed to start voting, Republicans still had not released the text of their secret, slimmed-down proposal, which reportedly includes a partial repeal of Obamacare’s employer mandate, a full repeal of the individual mandate, a one-year defunding of Planned Parenthood, and more money for community health centers. But leadership was telling members that this would not end with President Donald Trump in the Rose Garden signing this bill.
Instead, Majority Leader Mitch McConnell (R-Ky.) told senators that House Speaker Paul Ryan (R-Wis.) has promised to send this to a conference committee, and senators themselves were touting statements from House Freedom Caucus Chairman Mark Meadows (R-N.C.) that conservatives would not agree to the scaled-down bill.
Ryan’s spokeswoman AshLee Strong told HuffPost that “Conference Committee is one option under consideration and something we’re taking steps to prepare for should we choose that route after first discussing with the members of our conference.”
But there are caveats in both of those promises that should concern senators.
For one, conservatives in the House don’t actually hate the skinny repeal bill. Freedom Caucus member Randy Weber (R-Texas) told HuffPost on Thursday that a repeal of the employer and individual mandates was “better than nothing,” and a senior GOP aide with a sense of the Freedom Caucus said he thought conservatives would ultimately prefer the skinny repeal over the product of a conference, in part because it would probably save more money.
Excusing the freshman representatives, every House Republican has previously voted to repeal the individual and employer mandates, and excusing some waffling about not having read the bill, most Republicans HuffPost talked to on Thursday said they could, in fact, support just passing the skinny repeal.
Why even go to conference, wondered Rep. Chris Collins (R-N.Y.). “If it’s skinny repeal or nothing ... I’m going to vote for it,” he told reporters.
“I’m happy with it,” said Rep. Daniel Webster (R-Fla.), who had reservations about the House plan but ultimately voted for it.
Another Republican in that boat was Rep. Mark Amodei (R-Nev.). Amodei was one of the last Republicans to flip to yes in the House, and he did so after discussing the Medicaid changes with Health and Human Services Secretary Tom Price. One draw for moderates in the skinny repeal is that it wouldn’t touch Medicaid, but it would blow up one of the most unpopular aspects of Obamacare: the mandates.
“The status quo is not something I can defend,” Amodei said.
One thing Amodei can defend, apparently, is the projected coverage losses under the skinny repeal. The Congressional Budget Office estimates that 16 million fewer people will have insurance as a consequence of this bill, and those who do buy insurance will face 20 percent higher premiums. But Amodei said those losses would be a result of people choosing not to buy insurance. “Which, I’m not saying is a great idea, but it’s like, 16 million more being uninsured, if some of that is voluntarily, it’s not 16 million people being unpleasantly surprised,” he said.
Some Republicans say they wouldn’t go along with the plan. Rep. Peter King (R-N.Y.) was emphatic that he wouldn’t take it. And, again, Meadows told HuffPost Thursday there simply wasn’t “enough appetite” to pass the scaled-down bill in the House. But even Meadows acknowledged the public would hear some Freedom Caucus members say the skinny repeal is a good idea. “Oh yeah, you will. You’ll hear differently from some,” he said.
Sen. Lindsey Graham (R-S.C.) said during a news conference Thursday that “the skinny bill, as policy, is a disaster.”
And while Meadows talks a big game about ensuring that this isn’t the final legislation, that opinion could change quickly in one Freedom Caucus meeting ― or one sit-down with Trump.
The truth is, if it came down to this bill or no bill, it would be difficult for House Republicans to vote no on repealing the mandates.
“You have to separate politics from policy on what’s being talked about,” Freedom Caucus member Mark Sanford (R-S.C.) said. “I think the politics are tough for a House Republican member to vote no on that, given it’s, quote ‘doing something on the repeal of the Affordable Care Act.’”
But, Sanford continued, “from a policy standpoint,” just doing skinny repeal would “exacerbate” some problematic trends in the individual insurance marketplace, particularly with respect to increasing premiums.
It’s a question of whether Republican politicians could put policy before politics.
At no point in this entire debate have Republicans chosen to remove politics from the conversation and focus on outcomes.
Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander (R-Tenn.) suggested yesterday that enacting skinny repeal would not be a solution, but he’s clearly supporting the final version of whatever Republicans produce.
Sen. Bob Corker (R-Tenn.) told reporters Thursday that the substance of the bill doesn’t matter. “What’s relevant is getting to conference,” Corker said.
But that’s only true if the House couldn’t pass this bill if protracted negotiations failed.
Sen. John McCain (R-Ariz.) acknowledged that he was concerned the House would do just that, even after getting the assurances of House and Senate leadership. Asked Thursday afternoon where he stood on the bill, McCain said he doesn’t support the skinny repeal at this point.
Even the GOP leaders who promise that they’ll go to conference can’t definitively say this process won’t end with the House just taking whatever the Senate passes. Majority Whip John Cornyn (R-Texas) raised that possibility yesterday, and GOP leadership member Roy Blunt (R-Mo.) ― himself a former leadership member of the House ― was advocating the press take an incremental approach.
Asked whether Ryan had committed to never bringing up the skinny repeal, Blunt said he had told us “all I know.” But on Sept. 30 when the reconciliation bill is due to expire, if it’s a choice between skinny repeal or current law, would Blunt advocate that the House just pass the bill? Blunt told reporters to take this “one step at a time.”
“Anticipating failure is usually not the right first step,” he said.
But pressed again whether this would be better than Obamacare, Blunt conceded he thought this bill would be “a significant step in the right direction.”
It’s those opinions and the less-than-ironclad promises that are giving senators pause.
When Sen. Susan Collins (R-Maine) was asked if it was responsible for Republicans to disregard the policy outcomes of their yet-to-be proposed legislation, to just treat this bill like a procedural vote, she emphasized that there was a commitment from Ryan to go to conference.
But if that conference isn’t fruitful?
“Right,” Collins said, cutting HuffPost off, shrugging her shoulders in agreement.
Igor Bobic contributed to this report.